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The general aim and clinical objective of this trial is to determine the effect of telmisartan 80 mg compared to losartan 50 mg + HCTZ (Hydrochlorothiazide) 12.5 mg on reduction of blood pressure (BP) in patients with mild to moderate hypertension as assessed by 24 hour Ambulatory Blood Pressure Monitoring (ABPM) and trough sitting BP cuff measurements at the end of the treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Telmisartan | Experimental | 4 weeks placebo run-in, 6-weeks fixed dose period |
|
| Losartan + Hydrochlorothiazide | Active Comparator | 4 weeks placebo run-in, 6-weeks fixed dose period (Losartan 50 mg / HCTZ 12.5 mg) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Telmisartan | Drug |
| ||
| Losartan + Hydrochlorothiazide |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in 24-hour mean diastolic blood pressure measured by ABPM | Baseline (Day 28 of run-in period) and day 42 |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in 24-hour mean systolic blood pressure measured by ABPM | Baseline (Day 28 of run-in period) and day 42 | |
| Change from baseline in systolic and diastolic blood pressures during other time periods during the 24-hour ABPM profile | Baseline (Day 28 of run-in period) and day 42 |
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Inclusion Criteria:
Exclusion Criteria:
Pre-menopausal women (last menstruation ≤ 1 year prior to date of consent):
Mean seated diastolic blood pressure (DBP) > 114 mmHg or mean seated systolic BP > 200 mmHg, by manual cuff
Any known hepatic and/or renal dysfunction as defined by the following laboratory parameters:
Clinically relevant hypokalemia
Known or suspected secondary hypertension
Known bilateral renal artery stenosis; renal artery stenosis in a solitary kidney; post-renal transplant patients, presence of only one functioning kidney.
Congestive heart failure (CHF) (NYHA (New York Heart Association) class CHF III-IV)
Unstable angina within the past 3 months; stable angina where a change in nitrate therapy (dose or frequency) during the run-in period was required
Stroke within the past 6 months prior to start of run-in period
Myocardial infarction or cardiac surgery within the past 3 months prior to start of run-in period
PTCA (percutaneous transluminal coronary angioplasty) within the past 3 months prior to start of run-in period
Previous history of angioedema
Sustained ventricular tachycardia, atrial fibrillation, atrial flutter or other clinically relevant cardiac arrhythmias as determined by the investigator
Hypertrophic obstructive cardiomyopathy, hemodynamically relevant stenosis of the aortic or mitral valve
Patients with unstable insulin-dependent diabetes mellitus (risk of hypoglycemia or HbA1c ≥ 10 % in history within 6 months prior to start of run-in period)
Known drug or alcohol dependency within the past 6 months period prior to start of run-in period
Concomitant administration of medications known to affect blood pressure, except medications allowed by the protocol
Patients receiving any investigational therapy within one month of signing the informed consent form
Known hypersensitivity to any component of the formulations
Any clinical condition which, in the opinion of the investigator, would not allow safe completion of the protocol and safe administration of trial medication
Concomitant use of lithium or cholestyramine or colestipol resins (potential drug interactions with HCTZ)
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D000077333 | Telmisartan |
| C505809 | hydrochlorothiazide, losartan drug combination |
| ID | Term |
|---|---|
| D001713 | Biphenyl Compounds |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
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|
| Placebo | Drug |
|
| Change from baseline (Visit 2) in trough systolic and diastolic blood pressures measured by cuff sphygmomanometer | Baseline (Day 28 of run-in period) and day 42 |
| Number of patient with of adverse events | up to 10 weeks |
| Changes from baseline in pulse rate | Baseline (Day 28 of run-in period) and day 42 |
| Changes in physical examination | Screening and day 43 |
| Changes in laboratory parameters | Screening and day 43 |
| Changes in 12-lead electrocardiogram (ECG) | Baseline (Day 29 of run-in period) and day 43 |
| D006838 |
| Hydrocarbons |
| D009930 | Organic Chemicals |
| D001562 | Benzimidazoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |